Child sexual abuse is the exploitation of a minor for the sexual gratification of someone else. This can include unwanted sexual touching, talking, showing the adult's genitals to the child or showing the child obscene materials, among other things. Exactly what constitutes sexual abuse is difficult to define; factors that help to place something in or out of the abuse category include the child/adolescent's ability to make an informed decision about participating in what went on, the child/adolescent's age, the older person's amount of power and intimidation over the younger one, and the laws of their locality. The abuser is not necessarily an adult; children can be abused by older children as well. (endive wanted to point out: "Although typically the abuser is older, many children are abused by someone in their own age group. Of these offenders, most were also victims of sexual abuse, but in many states there are little or no laws concerning treatment of young children with sexual behavior problems.")
As E. Sue Blume puts it, "once touch has moved from safe, nondemanding affection to confusing, inappropriate sexuality, the damage is done." Child Abuse -- Fear In The Home calls sexual abuse "possibly the most devastating form of child abuse."

Abusers come from all races, economic classes, and cannot otherwise be identified except by those they have abused. Those who have studied sexual abusers come up with quite different conclusions as to why they did it. However, the majority of child sexual abuse is done by someone known to the victim; it is usually NOT a stranger luring children or teens into private places, but someone who has an excuse for spending time with their prospective victim. Statistics differ as to exactly what percentage of sexual abuse is done by familiar people; the books I have used as sources give figures for the United States ranging from 75% to 95% of sexual abuse being done by someone known to the child. One book cites the American Humane Association's breakdown of sexual abusers into 42% who are a natural parent of the child, 23% who are some other blood relative, and 35% other (this included foster and step-parents). In these cases when sexual abuse is done by people the child or teenager knows, it violates a bond of trust between the young person and their family member, caretaker, teacher, coach, adult friend, or other close person, the trust that the older person will not use their physical strength or adult authority to hurt the young. Being used for another person's sexual gratification, with no real thought of what effect it may have on the one being so used, is unpleasant for adults; for someone too young to be emotionally ready for sex it can be traumatic. "A child who cannot refuse, or who believes that she cannot refuse, is a child who has been violated," says Blume, and children are taught to do what grownups tell them to, especially when it is supposedly because of love.

Most abusers tell their victim that whatever happened should be kept secret. They may say that no one else will believe the story, that the child will be blamed for causing the sexual activity, or give threats (fabricated, such as threatening to harm the child's pet; or, semi-realistic: "You'll be taken away and put in a foster home if you tell.") Especially when the abuser is someone the child/teen trusted, that trust doesn't die immediately; love or loyalty brings a desire not to get their abuser in trouble. Sexual abuse may have gone on for years before a victim decides to disclose what is happening, or they may not tell until after it ends, if ever. Parents and others working with children and teens need to be open to hearing, or they will not be trusted with the child's feelings. It is also fairly common to avoid thinking about the abuse because it is too painful, especially when it goes on for a long time; people really do forget that they were abused, but it is forgetting on purpose, a defense mechanism. Even while abuse is taking place, some people are able to dissociate and go into a near-trance or pretend that they are somewhere else.

Of course, some effects happen whether there was a trust bond to break or not. Physical harm can certainly result from sexual abuse, especially if it involved penetration of a small child (with genitals or objects), but the emotional harm is longer-lasting. The feelings of discomfort and confusion associated with those abusive sexual acts don't just go away because one has grown older and found a non-abusive sexual partner; as I write this it's been fifteen years since my grandfather last molested me and I still flinch from touches that remind me of his. Having sexual acts forced onto you at a young age can teach many unhealthy lessons: that you are only good for sex and don't deserve to be treated well; that sex is the only way to get attention or affection (many abusers seek out affection-starved children as easy targets); that people are not be trusted; that it's OK to use people as you were used; that sex is dirty and secret and shame over being involved in it; that you are powerless and cannot stop being used by others; that you are not safe unless you purposely make yourself unattractive; that the only thing that you have control over is the way your body looks; guilt from feeling as if you didn't do enough to stop the abuse or for any parts that were physically enjoyable; and other items. It's not surprising that people who go into therapy for what seem to be unrelated issues end up dealing with past sexual abuse; it can affect all one's relationships with people.

More attention is usually given to abused females, but as these statistics show, males are also sexually abused. All my sources agree that 80% to 90% of abusers are male, but there are female abusers of both boys and girls; those who are abused by women often are even more reluctant to disclose the abuse because it does not fit the stereotypes. Blume's Secret Survivors says of her focus on women:"The aftereffects I describe are inextricably intertwined with the social experience and psychological training of women." However, this does not mean that abused boys do not show aftereffects, and until recently they have had substantially more difficulty finding resources to help themselves than those abused as girls have. Male victims of male abusers also have the added difficulty of society's homophobia to deal with; they worry that being abused by a member of the same sex has made them gay (even if they aren't now and have never been attracted to the same sex). This sometimes leads to their becoming homophobic as a way of trying to prove to themselves and others that they aren't gay. (In fact, most male abusers of males consider themselves to be heterosexual.)

Sexually abused children may show behavior changes, including: apparent personality changes (happy child is suddenly depressed); physical complaints such as stomachaches; nightmares; reluctance to go to certain places or have certain people around; regressive behavior (acting younger than they are); and playing sexually with dolls or playmates. Teens who are being abused often run away. Of course, physical signs such as injury to the genitalia are even more obvious, but the behavioral changes are definitely prompting for a parent or other authority figure to ask the child about the possibility of abuse. If abuse of any kind is reported to you, believe what you are hearing. It is extremely rare for children to lie about having been sexually abused (why would a child make up something so painful and difficult to deal with?) Reassure the child that it is not their fault, thank them for their trust in you, and explain that the abuse needs to be reported to authorities to stop the abuser from hurting others. Sometimes the story is retracted under pressure from the abuser (or family) or to avoid the difficulties of a formal investigation -- this does not generally mean that it was originally a lie, merely that the child/adolescent wants to keep things from getting worse than just the abuse by itself. (However, young children have been shown to embellish the story if they have to tell it again and again, or add things if they think it will please the interviewer. This still doesn't mean they started out lying.)

How can one prevent this kind of thing happening? The most important thing is to teach the child that they have the right to say no to anyone, even family or friend, who is doing something that makes them uncomfortable. Traditional "don't talk to strangers" programs fall very short here, because so little sexual abuse is actually done by strangers. Years of being ordered, "Now kiss Granddaddy good night" when you don't want to, makes it seem less likely that anyone will care that he, or somebody else, is forcing other kinds of touch on a 5th grader. Several picture books on the subject exist (My Body Is Private, Your Body Belongs To You, etc.) and all emphasize that other people touching "anything covered by a bathing suit" except for necessary washing or medical examinations should be reported to a trustworthy adult. All those I have read are well-done and not going to scare the child. Going over this kind of thing with the child also makes it clear that you will listen and believe if told about something happening -- both children and teens often assume that no one will believe them, and unfortunately they are sometimes right. It's awfully hard for an adult to face the fact that a husband, father, brother, or someone else trusted with the child has molested them, and some people refuse to accept the possibility.

Knowing distinct names for all the "private parts" helps, and using them enough that the child is not too embarrassed to say those names -- this makes it easier to realize when exactly "bad touch" is taking place. I will testify from personal experience that if I had had some idea what the hell was going on the first time Granddaddy pulled out his penis in the laundry room, I would have run away and locked myself behind some other door until my mom and Grandmother got home. Several years later when I was fourteen and he tried to feel me up, I did know what was happening, and I pushed him out the door and locked it behind him. Knowledge gave me courage that was he was trying to do was not acceptable.
Parents often want to wait as long as possible before talking about sex with their kids, but American Humane Association figures say the average age of molested children is 9.19 years -- just think, that means half the molested kids are younger than 9.

Historically, child sexual abuse has not been viewed as all that common. Sigmund Freud assumed that the number of female patients talking about incest in their past meant that women all imagined the same thing rather than that it actually happened frequently among people with psychological problems. The Kinsey organization said that "heterosexual incest happened more frequently in the thinking of clinicians and social workers than it does in actual performance." Despite the statistics that have been collected in the past few decades, some people still hold this view. Research is difficult to do for various reasons: the number of unreported cases, the difficulty of working with adult survivors who may or may not be able to remember everything clearly, and the overlap of the aftereffects of sexual abuse with those of other problems in the family of origin. Estimates vary wildly as to how many people experience sexual abuse before the age of eighteen. Any children experiencing sexual abuse is too many, but even the most conservative figures are shocking.

Beginning to Heal/The Courage To Heal -- one out of three girls, one out of seven boys.

Child Abuse -- American Humane Association report says 100,000 cases reported in 1984; U.S. Department of Health and Human Services report says 155,900 cases reported in 1986. (Note: this book also states that the number of unreported cases is estimated to bring the total to over 250,000.) Four times as many females are abused as males.

Child Abuse -- Fear In The Home -- 1990 "National Child Abuse and Neglect Data System" reports 138, 357 from the 44 reporting states. They also note the American Humane Association's estimate is 132,000 children sexually abused each year in their 1998 report, and that a 1985Los Angeles Times nationwide poll found that 27% of female respondents and 16% of male ones had been sexually abused.

Coping With Incest -- one in three girls, one in four boys from one source, 27% of females, 16% of males from another, for all child sexual abuse; 83,000 cases of incestuous child sexual abuse reported in 1986; 375,000 in 1990 (they hypothesize that famous people such as Oprah Winfrey and Roseanne revealing that they had been incestuously sexually abused increased the rate of reporting.)

Secret Survivors -- refers to reports ranging from 25% of all females to 38%; hypothesizes that this may be too low because of unreported cases.

Sexual Abuse And Incest -- 20% to 25% of all children; one female in four and one male in eight in FBI statistics; 28% to 38% of females and 15% to 20% of males from other surveys.

As an adult, the effects of sexual abuse vary; the past continues to influence responses in the present. Survivors are often very sensitive about their personal space and cannot stand feeling trapped or constrained (even a hug can feel like a trap for me sometimes). Others seem to have no personal boundaries because they never really got a chance to establish them in youth. In either case, understanding other people's boundaries becomes difficult. Some become very assertive because they finally have a chance to control their own lives; others may not appear to be able to make their own choices. Survivors are likely to have a distorted view of the relationship between power and sex. A lot of odd behaviors can turn out to be remnants of coping mechanisms; for example, it never occurred to me that my unwillingness to wear shorts or skirts shorter than ankle-length, despite living in Florida, could be rooted in being a survivor until I read one of the items on Blume's "Aftereffects Checklist" ("wearing a lot of clothing, even in summer, baggy clothes...") Many psychologists consider the effects to be Post-Traumatic Stress Disorder.

Healing can involve going through emotions that seem worse than the feelings from before confronting the abuse. But reaching a point where the past is no longer controlling one's life is worthwhile. As Bass and Davis put it, "deciding to actively heal is terrifying because it means opening up to hope. For many survivors, hope has brought only disappointment. Although it is terrifying to say yes to yourself, it is also a tremendous relief when you finally stop and face your own demons." This can often be triggered by events such as having a newly serious relationship, breaking an addiction, becoming a parent yourself, having an abuser (or people you didn't want to tell) die, or even a book, movie, or TV show about sexual abuse. Many survivors go through what Bass and Davis call an "emergency stage" where it seems that thinking about the sexual abuse is all they do, but this does die down. Books such as The Courage To Heal and support groups (even online ones) can help one get through difficult stages.